Provider First Line Business Practice Location Address:
1122 E TYLER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-7138
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-428-5566
Provider Business Practice Location Address Fax Number:
956-423-5818
Provider Enumeration Date:
10/14/2010